CompCare Networx ED A medical aid plan: 2018

View all plans in this scheme.
Please note that these benefits are still being updated as more information is made available to us. Always consult with your broker before making final decisions regarding your healthcare cover.

COSTS and OVERVIEW:
Networx ED A
Quick Overview
Main: Adult: Child:
Total Cost pm: R R R
Gap (optional): KaeloXelus: R350 per family
(R600 per family if anyone is 60yrs+)
Overal Limit: Unlimited
PMBs: Day-to-day expenses for PMBs (eg. cancer) are always paid for by the scheme, according to protocols. Find out more
Children:
Income band: This plan is only available to households with income in pm band.
View other income bands
See full benefits below

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IN HOSPITAL PROCEDURES:
Networx ED A
Benefits Gap benefits
Payout Rate for Specialists: 2018 benefits will be posted soon!
  • Up to 500% of scheme rate
  • In case of admission related to accident:
    • R300 per day, for days 1-13
    • R600 per day for days 14-20
    • R1,200 per day for days 21-30
Hospital Choice: 2018 benefits will be posted soon!
  • R12,800 per family per year for use of a non-network hospital
Specialised Radiology: 2018 benefits will be posted soon!
Supplementary Services: (Physio, etc) 2018 benefits will be posted soon!
Transplants: 2018 benefits will be posted soon!
Co-payments:
  • Gap covers co-payments for most scopes and a defined list of other procedures, incl MRIs etc See full list
Alternatives to hospitals: 2018 benefits will be posted soon!
Casualty: 2018 benefits will be posted soon!
Other: 2018 benefits will be posted soon!
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OUT OF HOSPITAL BENEFITS:
Networx ED A
Benefits Gap benefits
GP consultations: 2018 benefits will be posted soon!
Childcare:
  • No benefit
Specialists consultations: 2018 benefits will be posted soon!
Pathology: 2018 benefits will be posted soon!
General radiology: 2018 benefits will be posted soon!
Specialised radiology: 2018 benefits will be posted soon!
Supplementary Services: (Physio, etc) 2018 benefits will be posted soon!
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MATERNITY BENEFITS:
Networx ED A
Benefits Gap benefits
Hospital stay: 2018 benefits will be posted soon!
Consultations: 2018 benefits will be posted soon!
Scans: 2018 benefits will be posted soon!
  • No benefit
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CANCER (ONCOLOGY):
Networx ED A
Benefits Gap benefits
Overall coverage (in and out of hospital): 2018 benefits will be posted soon!
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DENTISTRY:
Networx ED A
Benefits Gap benefits
Dentistry: 2018 benefits will be posted soon!
  • Dental reconstruction due to due to trauma or oncology treatment: R40,000 per event
  • Full cover for in-hospital co-payments
Orthodontics: 2018 benefits will be posted soon!
  • No benefit
Maxillo Facial Surgery: 2018 benefits will be posted soon!
  • Dental reconstruction as result of trauma or oncology: R40,000 per event
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MEDICATION:
Networx ED A
Benefits Gap benefits
Chronic: 2018 benefits will be posted soon!
  • No benefit
Acute (presrcibed) medication: 2018 benefits coming soon. 2017 benefits:
  • Paid by scheme
Over-the-counter: 2018 benefits coming soon. 2017 benefits:
  • No benefit
  • No benefit
Birth Control: 2018 benefits coming soon. 2017 benefits:
  • R95 per month
On Discharge: 2018 benefits coming soon. 2017 benefits:
  • 7 days supply and R 280 per discharge
  • No benefit
Biological:
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OPTOMETRY:
Networx ED A
Benefits Gap benefits
Optometry: 2018 benefits will be posted soon!
  • No benefit
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MENTAL HEALTH:
Networx ED A
Benefits Gap benefits
In-hospital: 2018 benefits will be posted soon!
Out-of-hospital: 2018 benefits will be posted soon!
Trauma:
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OTHER BENEFITS:
Networx ED A
Benefits Gap benefits
General Appliances: 2018 benefits will be posted soon!
  • No benefit
1.1. Hearing Aids: 2018 benefits will be posted soon!
  • No benefit
1.2. Wheelchairs: 2018 benefits will be posted soon!
  • No benefit
Dialysis: 2018 benefits will be posted soon!
HIV: 2018 benefits will be posted soon!
  • No benefit
Emergency Transport:
  • No benefit
International Insurance: 2018 benefits will be posted soon!
  • No benefit
Other: 2018 benefits will be posted soon!
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WELLNESS/PREVENTATIVE BENEFITS:
Networx ED A
Benefits Gap benefits
Flu vaccination: 2018 benefits will be posted soon!
  • No benefit
Pneumonia vaccines: 2018 benefits will be posted soon!
  • No benefit
Back Rehabilitation Programme: 2018 benefits will be posted soon!
  • No benefit
Biometric Screening: 2018 benefits will be posted soon!
  • No benefit
Child Immunisation: 2018 benefits will be posted soon!
  • No benefit
Pap Smear: 2018 benefits will be posted soon!
  • No benefit
Mammogram: 2018 benefits will be posted soon!
  • No benefit
PAS Test: 2018 benefits will be posted soon!
  • No benefit
HIV Test: 2018 benefits will be posted soon!
  • No benefit
Other:
  • No benefit
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PROSTHETICS:
Networx ED A
Benefits Gap benefits
Overal Limit:
Sub-limits:
  • An additional R40,000 per sublimit, per event

    Important!
  • Unless specified, assume that all benefits are paid are paid at 100% scheme rate
  • No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
  • “Unlimited” benefits are still subject to authorisation, protocols and sublimits
  • Assume that all benefits need to be pre-authorised